How your lifestyle affects your fertility

It’s almost a cliché that diet and exercise choices have a major impact on various health issues. Is fertility, too, on the list? Yes, say experts.

The National Family Health Survey-4 (2015-16) suggested that infertility affects about 10 per cent of people in India and it is no longer an urban phenomenon, nor is it confined to women.

Recent studies point out that increasing infertility rates are a result of changed dietary patterns, lifestyle choices resulting in stress and obesity- mostly caused by lack of physical activity. But is there something, those trying to conceive can do to increase their chances? The experts we spoke to come up with some seemingly simple measures.

Watch the weighing scale

Both men and women, who are trying for a baby, should aim for a body mass index of 18.5- 25, suggests Dr Tanvi Tuteja, a gynaecologist with K J Somaiya hospital. “Both underweight and overweight people are likely to face fertility issues as high or low BMIs are linked with disruption of normal process of a consistent and timely ovulation in women and sperm mobility and count in men,” she explains.

Dr Prayas Kulkarni, a city based infertility experts informs that Nurses’ Health Study — a systemic series of research in the US — that has been tracking the effect of nutrition, hormones, environment and several other factors on women’s health — has termed the range of 20-24 BMI as the “fertility zone”. “Having a weight in that range has emerged as the best for getting pregnant. Relatively small changes are often more than enough to have the desired effects of healthy ovulation and improved fertility,” he says. If you are too lean, for example, gaining 3-5 kgs can sometime be enough to restart ovulation and bring menstrual cycle on track. For those who are marginally overweight, losing just about 5-10 per cent of body weight can bring the dash of luck required to help conceive.

Dr Kulkarni also stresses that overweight men are not as fertile as their healthy weight counterparts. “Excess weight can lower testosterone levels, disrupt the ratio of testosterone to estrogen — men to make some of this hormone, just as women have some amount of testosterone in their bodies — and obstruct the production of sperm cells that are good swimmers.”

However, you should also see that you don’t lose or gain weight too fast. “It is known that gross weight loss or gain can cause hormonal imbalance, which results in insulin resistance. This is an important reason that may impair ovulation,” warns Varsha Gorey, chief dietitian with Apollo Hospital in Navi Mumbai.

Slow carbs, not no carbs

Diabetologist and endocrinologist Dr Pradeep Gadge says that lowcarbohydrate diets may help you maintain a healthy weight, reduce insulin levels and encourage fat loss, all while helping menstrual regularity. And it's not just the amount of carbs that's important, but also the type. “Refined carbs that are easily digested and called fast carbs — such as sugary foods and drinks, processed grains like white bread, maida or processed rice — can be problematic. These carbs are absorbed very quickly, causing spikes in blood sugar and insulin levels and not good for fertility,” he elaborates.

And higher the fast carb in the diet — higher the glycemic load (a measure of both the quantity and quality of a carbohydrate in a meal) in the body, Dr Gadge says. Several studies have shown that women in the highest glycemic load category are almost 90 per cent more likely to have ovulatory problems.

According to Munmun Ganeriwal, a nutritionist and fitness consultant and founder of Yuktahaar, the whole grains (such as jowar, bajra, nachni, wheat, rice) that you eat in the form of rotis, bhaat, thepla, bhakri are not just carbs, they are also rich in fibre, B vitamins, zinc, iodine, and iron. “All of these have immune supporting properties and are essential for hormone synthesis, healthy sperm development, improved egg quality, regulated ovulation and even delay the aging of the ovaries,” she points out.

The dairy and fat factor

A study published in the Journal of Clinical Endocrinology & Metabolism, in 1993, used magnetic resonance imaging (MRI) scans to show that low body fat disrupts ovulation. “Consumption of dietary fats are very important for fertility and the development of the foetus. Not only are essential fatty acids important, but saturated fats and cholesterol are equally important. Cholesterol is a precursor to all hormones produced in the body, including progesterone,” says Ganeriwal.

What is only needed then is to make sure it is from the right foods. Regular consumption of dairy like milk, cheese, curd, ghee and white butter makes for one of the best whole fat foods. It can also help alleviate the issue of infertility in men, Ganeriwal says. “Dairy is a rich source of Vitamin B12 which has been shown to improve sperm quality and production.” It also may help to boost the endometrium lining in egg fertilization, thereby decreasing the chances of miscarriage. Deficiency of B12 increases the chances of irregular ovulation, and in severe cases stop ovulation altogether.

Tripti Gupta, lifestyle nutrition consultant and founder of iPink The Color of Health, emphasises that, if you are not lactose intolerant then dairy should form an essential part of your daily diet in the form of curds, paneer, buttermilk or just plain milk. “Dairy offers essential B complex vitamins and calcium which are crucial for our physical wellbeing and should not be compromised,” she says.

The importance of working out

Baby, we were born to run — this Bruce Springsteen song about young love leaving the comforts of home and towns, should also be a tagline for those trying to have babies.

Dr Kulkarni says that long inactivity deprives muscles of the constant push and pull they need to stay healthy and sap their ability to respond to insulin and to efficiently absorb blood sugar. “Now, when that leads to too much blood sugar — it hampers ovulation, conception and pregnancy,” he says.

Various findings from the Nurses’ Health Study and some other researches have highlighted that exercise can be a boon for fertility. “These crucial findings establish a vital link between activity levels and chances of getting pregnant,” Dr Kulkarni adds but cautions that some women need more exercise than others while some others might be, actually, overdoing it. “Instead of focusing on an absolute duration, try aiming for the fertility zone or a range of exercise that offers the biggest window of opportunity for fertility. Being in the fertility zone ensures that you are not overdoing or underdoing exercise,” he suggests.

For most women, this means getting about 30 minutes of daily workout. But if you are carrying more kgs than is considered healthy for your height — ie a BMI over 25 — you may require to exercise for an hour or more every day. “On the contrary, if you are lean or BMI is less than 18.5, you should aim for about 45 minutes of daily easy to moderate exercise for a few months as it will help you build your stamina and overall health but will also ensure that you are not burnt out post exercise regime and lose further weight,” Dr Kulkarni says.

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